The Embryology Laboratory at the Strong Fertility Center is a state-of-the-art facility accredited by the NYS Department of Health. We offer a wide variety of laboratory techniques to help patients achieve success with assisted reproduction. These include in vitro fertilization with standard insemination, Intracytoplasmic Sperm Injection (ICSI), Assisted Hatching (AHA), embryo cryopreservation, blastocyst culture, TESE and MESA for male factor, and embryo biopsy for pre-implantation genetic diagnosis. Following are step-by-step descriptions of the IVF procedures.
Step 1: Control Ovarian Hyperstimulation (COH)
COH is done using different protocols. The most common one is a long GnRH-Agonist (Lupron) protocol where the secretion of gonadotropin hormones is suppressed in order to prevent premature ovulation. Once optimal suppression is achieved, the next step is the recruitment of multiple follicles by daily injections of gonadotropins. Ultrasound imaging and hormone assessments are used to monitor follicular development. When the lead follicles have reached the appropriate size, the final maturation of eggs is done by HCG administration. Egg retrieval is scheduled 34-36 hours after HCG injection.
Step 2: Egg Retrieval
Egg retrieval is performed in a surgical suite under intravenous sedation. Ovarian follicles are aspirated using a needle guided by trans-vaginal ultrasonography. Follicular fluids are scanned by the embryologist to locate all available eggs. The eggs are placed in a special media and cultured in an incubator until insemination.
Step 3: Fertilization and Embryo Culture
- If sperm parameters are normal, approximately 50,000 to 100,000 motile sperm are transferred to the dish containing the eggs. This is called standard insemination.
- The ICSI technique is utilized to fertilize mature eggs if sperm parameters are abnormal. This procedure is performed under a high-powered microscope. The embryologist picks up a single spermatozoa using a fine glass micro needle and injects it directly into the egg cytoplasm. ICSI increases the chance that fertilization will occur if the semen sample has a low sperm count and/or motility, poor morphology or poor progression. If there are no sperm in the ejaculate, sperm may be obtained via a surgical procedure. ICSI is always used to achieve fertilization if the sperm is surgically retrieved.